Adler Insurance Inc

Arizona Medicare Expenses

Original Medicare coverage without a Medicare Advantage Plan or Medicare Supplemental Plan (Medigap) can cost you a lot of additional out-of-pocket expenses.

With original Medicare only, there is no cap on your annual out of pocket exposure. For example, if you had an extended hospital stay of 150 days, you would owe $43,582. If you were in the hospital for a year, you could owe more than $1.5 million. Selecting another option other than original Medicare only is strongly recommended.

However, there is an answer. Contact us to discuss additional benefits available at low or no cost.

The following are examples of out-of-pocket expenses under original Medicare:

Inpatient Hospital Care: For days 1-60, you pay an initial deductible of $1,260. For days 61-90, you pay $304 each day. For days 91-150 you pay $608 per day. You pay 100% thereafter.

Skilled Nursing Facility: For days 1-20 you pay nothing. For days 21-100 you pay $152 per day. You pay 100% thereafter.

Doctor Office Visits: After you pay your $147 annual deductible, you pay 20% of Medicare approved charges/amounts. If the doctor does not accept Medicare assignment as payment in full, you must pay an additional 15%.

Chiropractic Services: You pay 20% of Medicare approved charges/amounts for manual manipulation of the spine. If the chiropractor does not accept Medicare assignment as payment in full, you must pay an additional 15%.

Outpatient Surgery: You pay 20% of Medicare approved amounts for the doctor and the outpatient facility charges.

Ambulance: You pay 20% of Medicare approved amounts.

Emergency Care: You pay 20% of the facility charge and 20% of the emergency room physician charges.